Provider Demographics
NPI:1659941599
Name:HEALTH EASE NUTRITION PLLC
Entity Type:Organization
Organization Name:HEALTH EASE NUTRITION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLUBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RD, LN
Authorized Official - Phone:646-258-1483
Mailing Address - Street 1:13068 QUADE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-4939
Mailing Address - Country:US
Mailing Address - Phone:646-258-1483
Mailing Address - Fax:
Practice Address - Street 1:13068 QUADE LN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-4939
Practice Address - Country:US
Practice Address - Phone:646-258-1483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty